Symptoms, Causes, and Prevention for Dry Socket

Having dental work done is painful enough, but if you must have a tooth pulled (extracted), you may be in for a world of pain due to dry socket, which is clinically referred to as alveolar osteitis.

According to WebMD, only 5-percent of individuals develop dry socket after having a tooth pulled. Thankfully (you can stop holding your mouth now), this uncomfortable condition can be treated…

1. What Causes Dry Socket?

When a tooth is removed a blood clot will naturally form in the hole in the bone left behind in the days following extraction. The blood clot forms to provide protection to the nerves and bone underneath, allowing for healing to take place.

However, if the blood clot disappears (or becomes dislodged), dry socket can occur when the nerves and bone are suddenly exposed to all sorts of painful irritants, including food, fluids, and even air. Unfortunately, dry socket also leaves the area of extraction prone to awful pain and infection.

2. Dry Socket Symptoms

To say that dry socket is painful is an understatement for anyone who’s experienced this condition. And while discomfort and tenderness after a dental procedure can be common, dry socket is intense pain that doesn’t dissipate within a few days to a week.

Additional symptoms of dry socket include a foul taste in the mouth, bad breath, and a distinctive pain that radiates into your ear. You can also visibly see a dry socket if you look inside the hole left behind by an extracted tooth. You will likely see exposed white bone at the base of the hole, not a dark blood clot that should be present as protection.

3. Smoking Causes Dry Socket

If you suspected that smoking is a huge risk factor for dry socket development, you’re correct! According to, smoking, or more specifically nicotine, zaps the hydration and blood supply within the mouth. This can interfere with normal blood clot formation in the extraction area as part of the natural healing process.

If you smoke a pipe, cigars, or cigarettes try to stop smoking a few days prior to your dental extraction to prevent dry socket. Also, check with your dentist to see if any medications you’re taking may make you prone to developing dry socket.

4. Other Causes of Dry Socket

In addition to smoking, dry socket is often caused by the medications you take. For instance, oral contraception (i.e., birth control pills) can interfere with your body’s ability to clot following a dental procedure. If you take estrogen, ask you dentist to schedule your surgery during a time when you’re getting the lowest levels of the hormone and during the first 22 days of the menstrual cycle (when estrogen is likely most inactive).

Blood clot formation can also be hindered in individuals with a dense jawbone, a pre-existing infection (i.e., periodontal disease), or the presence of excess bacteria in the mouth. Certain habits (i.e., smoking, rinsing, or using a straw) can also lead to the ousting of a blood clot from the tooth socket.

5. Post-Surgical Precautions

Following a dental extraction, you can do your part to prevent dry socket by following precise after care instructions. The Mayo Clinic recommends avoiding any dehydrating beverages for at least 24-hours (i.e., coffee, caffeine, and alcohol) and also avoiding the use of a straw. Choose soft foods, such as smoothies, yogurt, and applesauce, instead of hard or spicy foods that can cause irritation.

Avoid smoking for at least 48-hours following dental surgery, and cleanse your mouth by gently brushing and rinsing with a lukewarm salt rinse after meals and throughout the day, while avoiding the extraction wound as much as possible. Any pain or suspect infection should be brought to your dentist’s attention immediately.

6. Dry Socket Treatment

If pain persists, you should see your dentist right away. If dry socket is diagnosed, your dentist may schedule follow-up appointments to clean and pack your tooth socket every few days with a special dressing to help the healing process and relieve pain.

Your dental professional may also prescribe a non-steroidal anti-inflammatory medication (i.e., ibuprofen) to relieve pain and anesthetize the extraction site. If infection is suspected, your dentist may also prescribe a mouthwash or oral antibiotics.


Emily Lockhart

Emily Lockhart is a certified yoga instructor and personal trainer. She believes that being healthy is a lifestyle choice, not a punishment or temporary fix to attain a desired fitness or body image goal. Anna helps her clients take responsibility for their own health and wellness through her classes and articles on ActiveBeat.